Facial Nerve Conduction after Sclerotherapy in Children with Facial Lymphatic Malformations: Report of Two Cases

Abstract

Surgical excision is thought to be the standard treatment of choice for lymphatic malformations. However, when the lesions are limited to the face only, surgical scar and facial nerve injury may impair cosmetics and facial expression. Sclerotherapy, an injection of a sclerosing agent directly through the skin into a lesion, is an alternative method. By evaluating facial nerve conduction, we observed the long-term effect of facial lymphatic malformations after intralesional injection of OK-432 and correlated the findings with anatomic outcomes. One 12-year-old boy with a lesion over the right-side preauricular area adjacent to the main trunk of facial nerve and the other 5-year-old boy with a lesion in the left-sided cheek involving the buccinator muscle were enrolled. The follow-up data of more than one year, including clinical appearance, computed tomography (CT) scan and facial nerve evaluation were collected. The facial nerve conduction study was normal in both cases. Blink reflex in both children revealed normal results as well. Complete resolution was noted on outward appearance and CT scan. The neurophysiologic data were compatible with good anatomic and functional outcomes. Our report suggests that the inflammatory reaction of OK-432 did not interfere with adjacent facial nerve conduction.

Sclerotherapy with bleomycin does not adversely affect facial nerve function in children with cervicofacial cystic lymphatic malformation

“…In 2 series with 128 cases and 21 cases, temporary palsy of the facial nerve following OK-432 sclerotherapy occurred in 2 patients and 1 patient, respectively [9,16]. Facial nerve conduction after sclerotherapy with OK-432 was evaluated by Lin et al [17] in only 2 patients, and nerve conduction and blink reflex were found normal in both.…”

Detrimental influences of intraluminally-administered sclerotic agents on surrounding tissues and peripheral nerves: An experimental study

“…Ideally, the administered agents should be retained inside the lumens of the veins in the VM, and should not damage the surrounding healthy tissues. However, percutaneous sclerother-apy can sometimes cause serious functional and cosmetic sequelae, such as peripheral nerve disturbances [3,8–11], cutaneous necrosis [10,12] and detrimental effects on the muscle [13]. Of these, peripheral nerve disturbances, such as facial nerve paralysis or recurrent laryngeal nerve paralysis resulting in vocal cord paralysis, represent serious problems [9].…”